Strengthening accountability of the global health metrics enterprise

Abstract

The development and use of indicators to reveal population health conditions and hold policy makers and the organisations they lead to account—what might be termed the global health metrics enterprise—has surged over the past two decades. The enterprise’s proponents point to its emancipatory effects, arguing that global health metrics uncover health problems and bring greater objectivity and accountability to policy making.1–3 Critics challenge the enterprise’s merits and are worried, among other concerns, that the enterprise transfers power from institutions in low-income countries to ones based in high-income countries, hampers the development of national health information systems, and privileges certain forms of knowledge over others.